Hip Arthritis

Arthritis of the hip is a disease which wears away the cartilage between the femoral head and the acetabulum, causing the two bones to scrape against each other, raw bone on raw bone. When this happens, the joint becomes pitted, eroded, and uneven, resulting in pain, stiffness, and instability. In some case, motion of the leg may be greatly restricted.

Osteoarthritis

Osteoarthritis is the most common form of arthritis in the United States. It is degenerative, and although it most often occurs in patients over the age of 50, it can occur at any age, especially if the joint is in some way damaged.

It is usually confined to the large weight-bearing joints of the lower extremities, including the hips and knees, but may also affect the spine and upper extremity joints. Patients with osteoarthritis often develop large bone spurs, or osteophytes, around the joint, further limiting motion.

Causes

Osteoarthritis of the hip is a condition commonly referred to as “wear and tear” arthritis. Although the degenerative process may accelerate in persons with a previous hip surgery, many cases of osteoarthritis occur when the hip simply wears out. Some experts believe there may exist a genetic predisposition in people who develop osteoarthritis of the hip. Abnormalities of the hip due to previous fractures or childhood disorders may also lead to a degenerative hip. Osteoarthritis of the hip is the most common cause for total hip replacement surgery.

Symptoms

The first and most common symptom of osteoarthritis is pain, usually occurring towards the groin area during weight-bearing activities such as walking. To decrease hip arthritis pain people usually compensate by limping, which reduces the force across the arthritic hip. Hip osteoarthritis may also result in loss of motion of the hip joint, causing difficulty in doing daily living activities such as putting on socks and shoes. As a result of the cartilage degeneration, the hip loses its flexibility and strength, and may develop bone spurs. As the arthritis worsens, the pain may increase and may become constant, even during non weight-bearing activities.

Treatment

Before considering total hip replacement surgery, your doctor and you may try various non-surgical therapies. An appropriate weight reduction program may be beneficial in decreasing force across the hip joint. However, weight reduction can be difficult for people with hip arthritis since the arthritis pain precludes them from increasing their activity and burning calories. An exercise program may be instituted to improve the strength and flexibility of the hip and the other lower extremity joints. Lifestyle and activity modification may be undertaken in an attempt to minimize the activities that are associated with hip pain. Finally, various medications such as non-steroidal anti-inflammatory drugs (NSAIDs) and/or nutritional supplements (Chondroitin/Glucosamine) to reduce pain and inflammation associated with the disease may be considered.

Assistive devices like a cane or a crutch can help to reduce the force transmitted through the hip joint during walking and thereby may help to decrease hip arthritis pain. If non-surgical treatment is unsuccessful, you and your surgeon may decide that a total hip replacement is the best available treatment option.

Rheumatoid Arthritis

Unlike osteoarthritis which is a “wear and tear” phenomenon, rheumatoid arthritis is a chronic inflammatory disease that results in joint pain, stiffness, and swelling. The disease process leads to severe, and at times rapid, deterioration of multiple joints, resulting in severe pain and loss of function.

Causes

Although the exact cause of rheumatoid arthritis is unknown, some experts believe that a virus or bacteria may trigger the disease in people with a genetic predisposition to rheumatoid arthritis. Many doctors think rheumatoid arthritis is an autoimmune disease in which the synovial tissue of the joint has been attacked by the immune system. The onset of rheumatoid arthritis occurs most frequently in middle age and is more common among women.

Symptoms

The primary symptoms of rheumatoid arthritis are similar to osteoarthritis and include pain, swelling, and the loss of motion. Other symptoms may include loss of appetite, fever, energy loss, anemia, and rheumatoid nodules (lumps of tissue under the skin). People suffering with rheumatoid arthritis commonly experience periods of exacerbation or “flare-ups” involving pain and stiffness in multiple joints.

Treatment

Treatment of rheumatoid arthritis may involve medications such as NSAIDs, aspirin and analgesics. Corticosteroids, such as prednisone may be prescribed, and are effective in decreasing the inflammation associated with rheumatoid arthritis. Side effects can occur with the use of corticosteroids, and close monitoring by a physician is essential.

Researchers have made progress in the treatment of rheumatoid arthritis and newer prescription drugs are now available. If non-surgical measures fail, you and your surgeon may decide that total hip replacement is the best treatment option to relieve your pain and help you return to an improved function level.